BMC strike coverage plan to cost over $4M

President and Chief Executive Officer David E. Phelps talks to the media about the logistics of staffing during the nurse's strike on Tuesday during a press conference on Monday, October 2, 2017.

GILLIAN JONES - THE BERKSHIRE EAGLE

President and Chief Executive Officer David E. Phelps and Chief Operating Officer Diane Kelly, R.N. talk to the media about the logistics of staffing during the nurse's strike on Tuesday during a press conference on Monday, October 2, 2017.

GILLIAN JONES - THE BERKSHIRE EAGLE

President and Chief Executive Officer David E. Phelps and Chief Operating Officer Diane Kelly, R.N. talk to the media about the logistics of staffing during the nurse's strike on Tuesday during a press conference on Monday, October 2, 2017.

GILLIAN JONES - THE BERKSHIRE EAGLE

"This is our first rodeo. Thankfully, it's not theirs."”

- David Phelps, Berkshire Health Systems president and CEO, on the 247 replacement nurses hired to cover Berkshire Medical Center shifts during a strike

PITTSFIELD — Busloads of replacement nurses from around the U.S. will report Tuesday to Berkshire Medical Center, key players in a more than $4 million plan to keep the hospital running during a strike that begins at 7 a.m.

In all, 247 registered nurses provided by U.S. Nursing Corp. will handle work normally performed by members of the Massachusetts Nurses Association, hospital leaders said Monday. The union called a one-day strike to highlight unmet demands after nearly a year of contract negotiations.

Hospital officials said Monday they expect to admit the usual number of patients this week, despite the strike and the four-day lockout that will follow. The hospital says its contract with U.S. Nursing Corp. required it to hire the replacement nurses for five days. That means replacement staffing will extend into the weekend.

The company is the same one that supplied replacement RNs to Tufts Medical Center in July.

"I would never have dreamed that this would be happening here," David Phelps, president and CEO of Berkshire Health Systems, said Monday.

"I worry about the scars," he said, referring to divisions among employees over the strike. "We'll have some work to do to pull this back together. It's an emotional time," Phelps said

But he and Diane Kelly, BMC's chief operating officer, said a month of preparations, including close reviews by the Division of Healthcare Quality in the state Department of Public Health, will enable the hospital to operate normally.

Kelly said she worked with a roughly 18-member team to shape a coverage plan during the strike. That 48-page document was approved by the DPH. Officials with the state health department will be in Pittsfield to monitor care.

The strike is also affecting the BMC Cancer Center at the Hillcrest campus in Pittsfield and Berkshire Health North in North Adams.

Pittsfield police officers will be on hand to monitor picketing that starts Tuesday, joined by representatives of the Berkshire sheriff's department and an outside security team hired by the hospital.

"We want everyone to be safe," Phelps said of the hospital's security preparations. He declined to say how many added security members will be on the scene.

Patients are being told to use the same parking and entrances. Special greeters will be on hand, the hospital says. Patients with questions about care during the strike can call the hospital's main number, 413-447-2000. A special team will handle their calls.

Phelps and Kelly said the hospital has not asked patients to reschedule elective procedures to other weeks. But it did delay the time arriving patients need to report in Tuesday, in an effort to avoid having them cross paths with nurses finishing their pre-strike shifts.

"So our patients don't have to get in the middle of that," Kelly said.

Training days

Though they begin work Tuesday, the replacement nurses trained in two groups of about 120 over the past two days in Pittsfield. Fourth-floor space in the Clock Tower Business Park complex on South Church Street was set up to allow the nurses to practice use of the hospital's information systems.

Though most BMC nurses normally work eight-hour shifts, the replacements will work in two 12-hour shifts.

Phelps spoke to the out-of-town nurses on both training days.

"I wanted them to know that this community was depending on them," Phelps said.

"We wanted them to know who we were," Kelly said. "We don't need to teach them how to be nurses. Even the equipment wasn't foreign to them."

An effort by The Eagle to visit the training area Monday afternoon was rebuffed by a BMC employee, who said the replacement nurses were instructed not to engage in interviews.

Kelly said the hospital began to ramp up its preparations soon after members of the MNA voted 442-92 in July to authorize a strike vote. The strike date was announced Sept. 22 by the union, which by law had to give a 10-day notice.

The hospital chose U.S. Nursing Corp. after getting positive reviews of how its nurses handled the Tufts strike July 12 and the subsequent four-day lockout there.

Kelly said her team, including Brenda Cadorette, BMC's chief nursing officer, supplied the outside company in early August with a list of nursing specialties needed and was able to select candidates from a list of available staff.

All of the replacement nurses are licensed to practice in Massachusetts and have no histories of disciplinary action, Phelps and Kelly said.

They've come to Pittsfield from as far off as Florida, Texas and Illinois.

The replacement nurses trained at specially designed stations, depending on the roles they'll perform at BMC.

"These people are used to change," Phelps said of the U.S. Nursing Corp. teams. "They know just what kind of questions to ask. This is our first rodeo. Thankfully, it's not theirs."

Once on the units, the nurses will return to their postings during the week. That's designed to minimize disruption for patients, Kelly said.

"They'll have a continuity of care," she said.

The replacement nurses will be assigned to units using the hospital's normal "core" staffing model, Kelly said.

Staffing has been a top issue in the past year's unfruitful contract negotiations. A three-year contract between the MNA and the hospital lapsed Sept. 30, 2016, but remained in effect until Sept. 1 of this year. Nonetheless, most of its terms continue to be honored.

Kelly said that during the week, she and others in a command center will monitor nursing coverage, comparing baseline needs with changes in the patient census. The in-patient count was 230 as of Monday, a number she termed normal.

Other arrangements

Phelps and Kelly said the more than $4 million cost of this week's coverage plan includes spending on enhanced security and other changes. That cost estimate reflects the savings the hospital will see because it is not paying its normal nursing workforce for five days.

The replacement workers will be paid more than the hospital's RNs normally receive, Phelps said, but noted that the hospital does not pay for their benefits. It is contributing to the cost of bringing the nurses to the Berkshires and housing them this week.

The hospital contacted its suppliers to determine which would not be willing to cross picket lines — and in that case to arrange for deliveries elsewhere.

Early Tuesday, nursing supervisors will help make the hand-off from overnight care by MNA members to the replacement nurses, addressing the needs of specific patients. That method is used to prevent the replacement workers from having contact with union members.

Kelly, who is herself a registered nurse, said she will make rounds to check on patients and monitor the coverage plan. She said her team will check nurse-patient ratios at the start and end of every shift — and at times in between.

The hospital's coverage grew out of an existing emergency operation plan. This week's response is noted in that document's category D, which refers to a "disturbance in normal operations."

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